Initial swelling of residual limb tissue after the operation is expected. This swelling (oedema) is a normal reaction to the operation. It can be prevented by applying pressure over the entire surface.
The purpose of applying pressure over the entire residual limb is to reduce the severity of the residual limb oedema and to shape the residual limb for your subsequent prosthetic fitting. This compression of the residual limb makes fitting your prosthesis easier and means you can obtain the prosthetic fitting sooner. In addition, compression promotes circulation in the residual limb. This reduces pain and helps improve healing of the scar.
A variety of compression therapy techniques are used: the residual limb is wrapped with elastic bandages, compression socks are used or a prefabricated silicone bandage known as a silicone liner is worn.
When the wound dressing or residual limb plaster is removed, compression dressings are applied using a special bandaging technique. In the first few days and weeks after the operation, your residual limb is bandaged by your therapist or nursing staff. This somewhat elaborate compression with elastic bandages has the advantage that the dressing can be individually adapted to your residual limb and amputation level.
The dressing is frequently removed in order to check how the residual limb is developing, whether the oedema is going down and how the scar is changing. The intervals are very short at first – sometimes the dressing is removed again after just half an hour in order to make sure that the residual limb was not bandaged too tight or loose. Then the compression dressing is worn for several hours as time progresses, for example also before and after wearing the interim prosthesis.
Later the nursing staff or your doctors can show you how to put the compression bandage on yourself. Have the bandaging process explained to you in detail in order to prevent mistakes, which could cause the residual limb to swell again or become irritated or injured due to wrinkles in the fabric or by wrapping it too tightly. Do not use metal clips to fasten the bandages, use adhesive tape. This prevents injuries.
It is important to clean the bandages thoroughly. Because the bandages absorb perspiration, they have to be washed daily with mild detergent or mild soap. Then they are best rolled up in a towel in order to absorb most of the water. Do not hang the bandages up after that, but lay them flat to dry. Only then will the bandages retain their elasticity.
You have to wear the compression dressing all the time until the residual limb heals. As soon as everything is healed, you can try to sleep one night without the dressing after consulting your doctor, orthopaedic technician or physiotherapist. If the residual limb exhibits pronounced swelling again the next morning, compression therapy has to continue.
Residual limb compression socks
Compression socks can also be used instead of bandages. These socks are elastic as well, and are available in various sizes. If none of the standard sizes fit you, these can also be made to measure. Like elastic bandages, the socks have to be washed daily and laid flat to dry so they do not lose their elasticity.
The advantage of residual limb socks is that they are easy to put on and take off. You can use garters attached to a hip belt to attach them. Or you use a pelvic band firmly connected to the sock.
Next to elastic bandages and residual limb socks, silicone liners are another compression option. Silicon liners, like residual limb socks, are available in standard sizes and custom-made to measure. The liner exerts even pressure on your residual limb, bringing it into the correct shape, while the elastic, skin-friendly silicone makes the scar soft and supple.
The best way to put on the liner is to turn it inside-out and then evenly roll it over your residual limb. In other words, do not pull it up like a sock, and be very careful to ensure that no wrinkles form and no air is trapped inside.
Clean your liner daily with a skin-friendly, unscented soap and warm water. If you perspire heavily, you should clean it more than once a day and possibly use a disinfectant. Have your orthopaedic technician explain the care of your liner in detail and observe the instructions for use.